Provider Demographics
NPI:1396172359
Name:TROMBLY, PATRICIA ANTONETTE (CNC)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANTONETTE
Last Name:TROMBLY
Suffix:
Gender:F
Credentials:CNC
Other - Prefix:MRS
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:TROMBLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNC
Mailing Address - Street 1:214 JALISCO PL
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-0232
Mailing Address - Country:US
Mailing Address - Phone:530-753-2237
Mailing Address - Fax:
Practice Address - Street 1:214 JALISCO PL
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-0232
Practice Address - Country:US
Practice Address - Phone:530-753-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education